I can’t believe this is happening but… I’m having the best summer I’ve ever had!!

I’m now 78 days post-op, or 11 weeks plus one day, or just a week shy of 3 months. Already!

When I took a surgery date for May 2018, I resigned myself to accept that I probably wouldn’t get to enjoy much of the summer. Instead, I imagined that I would be dealing with one of the many complications that can come with Phalloplasty. I assumed that I would be a bit depressed at my inability to be physically active and take part in good times with friends. While I was ready and willing to trade in my summer fun for my long awaited surgery, I’m very happy to say that I was wrong: I didn’t have any serious complications from my Stage 1 surgery or suffer from post-op depression, and I’ve been able to steadily increase my physical activity. I’m so grateful.

Minor Worries at Week 4

After my release from hospital, I spent 3 weeks in Portland recovering at a hotel. My time there was uneventful. My days consisted of eating, drinking lots of water, taking medications and supplements, doing wound care, light office work while reclined in bed, and watching a little NBA basketball on TV. With the exception of getting an amazing straight razor shave at the Portland Shave Shop (highly recommended!), I was not to sit upright, bend over or walk until the final week of my stay.

In The Cloud

I had a final check-up with Dr. Berli scheduled for 2 days before I was flying home. The night before my appointment, I noticed what appeared to be an area of about 1cm of wound dehiscence on the underside of my penis, at the base. It was a concerning discovery but I was relieved that it revealed itself before my appointment and not after arriving home. Dr. Berli has a way of making scary things seem OK and I have much faith in his expertise. While he didn’t think it looked serious, he instructed me to stay “in The Cloud” for an extra 2 weeks (6 weeks instead of 4.) The Cloud has its purpose but gets annoying after a time, and it’s socially awkward to walk around with what appears to be a very swollen groin, but this was certainly not devastating news.

In the days after getting home, the wound starting closing from the inside out, but I felt like it wasn’t healing as quickly as it should. On taking a closer look at it with a hand mirror, I noticed a few millimeters of a green Maxon suture sticking out. Putting a bit of pressure around that area caused some lymph fluid to ooze out. I snapped some photos and sent them to Dr. Berli. He diagnosed this as a suture abscess and advised me to pull the suture and snip it. I gave it a go but only managed to snip a small bit of it off—I was understandably nervous about pulling and snipping sutures! But Dr. Berli assured me that it was OK, nothing bad would happen. A couple of days later I tried again and managed to pull out and snip off a suture of a little more than 1cm in length. During weeks 5-8, a number of suture bits started pushing themselves out of my skin—nothing to worry about—and my earlier nervousness about pulling and snipping sutures dissolved away with my new familiarity with this task.

Healing Acceleration at Weeks 7 & 8

I saw Dr. Berli for another check-up just shy of 7 weeks post-op. The day before traveling to Portland for my appointment, the suture abscess wound had healed and I was able to retire The Cloud and wear normal underwear again. Yippee! By this point, I was hitting new milestones every day. At my appointment, Dr. Berli cleared me to go to a big concert that upcoming weekend, and much to my pleasure and surprise also said that I could swim now (in the ocean, lakes, just no pools or hot tubs.) I didn’t think I’d be able to swim until the end of summer, if at all this season.

At 8 weeks post-op, I resumed light workouts and some good sessions of wood chopping, gardening and landscaping. I also started walking 3km and swimming every day. Distance-wise, I could walk my normal 5km route except that it has a very big hill on it and walking downhill is still awkward feeling on my donor leg knee. I can bend my knee more than 45° now and that mobility is improving on a daily basis. My knee is still a bit swollen but no longer sore to touch. The area above my knee has gained about 50% sensation. Since a nerve was taken from my leg, I’m not expecting to get much more sensation back than this.

The donor site (right leg) feels fine. It’s a bit tight but not painful. I’m moisturizing it daily with coconut oil and Phytoplex cream that one of the nurses at OHSU gave me (which is basically safflower oil, glycerine and silicone plus a number of botanical extracts.) I’m also applying silicone lube for scar treatment.

 

My graft site (left leg) hasn’t caused any problems. The color of the scarring started improving around weeks 7-8 and is consistently progressing from red to brownish.

My penis is healing really well. Dr. Berli observed that it was still swollen at 7 weeks, and since then I’ve noticed it getting a little squishier, which I think means the swelling is dissipating. At the end of a day, it’s a bit firmer in the head versus the base but this too seems to be lessening. Its size fluctuated a bit from the days immediately after surgery until about 6 weeks post-op, and the girth evened out from base to tip, and this seems to have stabilized now but as noted it could still be a bit swollen so size may still change (and could continue to change subtly over the years.) I’m using silicone scar sheets to try to reduce the appearance of the scar from the long incision on the underside. Every day, I pass a lubed-up 16F catheter through the urethra to make sure it stays open (because I won’t pee out of it until after stage 2.) I noticed some touch sensation at the base of the penis fairly early on in healing, around weeks 2-3, but there hasn’t been any remarkable change to this since. I’m neither surprised or disappointed; gaining sensation is one of those things that just takes time.

Not having serious complications from Stage 1 and being able to return to physical activity sooner than I expected has been such a blessing! As a result, my mood has been great and I’m back to full productivity at work and in my garden.

I should hear about my Stage 2 surgery date within a week or so and then another countdown begins. I feel excited about getting to the other side of Stage 2 but also wary: I expect it to be an intense recovery and my anxieties around urinary complications will be high. I’m very hopeful for a good outcome, and that hope is buoyed by the fact that the technique used by Dr. Berli for urethral hookup is believed to be less prone to strictures. But having had a serious urinary complication from hysterectomy and being all too aware of what can go wrong, I know how difficult recovery could be. For now, I’m basking in the light of having made it through Stage 1, like a Champ!

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